Little by little, the American public is becoming aware that providing teens with a small amount of accurate sexual information seldom leads to avoiding sexual contact. Communities around the country are saying "no" to "
Just Say No" as a reliable way to deter the initiation of sexual activity with a partner during the teen years. But, we still have some learning to do as providers of sex education. Here's a study that shines a bright light on one aspect of the problem.
A study done in New York City involving 92 men and women between 18 and 24 enrolled at an urban city college found that even when armed with information, students often overestimated their safety from
sexually transmitted diseases. What researchers O'Sullivan, Udell and Patel (reported in The Journal of Sex Research, Nov. 2006) found was a seeming paradox in which young people continued to engage in unsafe sexual practices despite a moderate to high level of general knowledge about the risk of contracting
HIV. These college students were ethnically diverse and resided in inner-city neighborhoods characterized by very high rates of HIV. They recorded their sexual activity over a two-week period.
Despite their knowledge about
HIV transmission and the need to use condoms during intercourse, students engaged in risky sexual activity over the two-week period at relatively high levels -- as well as during the two months that preceded the study. This tells us that these young people had not effectively integrated general knowledge about HIV into their personal lives in ways that could help them prevent infection. Or it tells us that they were unwilling or unable to incorporate the few means of prevention available -- abstinence, sexual behaviors that did not exchange bodily fluids, or condom use.
How much were they ignoring what they knew?
Many were having intercourse within what they believed to be a
monogamous relationship. Whether that was, in fact, the case we cannot know -- about 80% had a romantic partner, but only one was married and nearly all of them did not live with their sexual partner but at the home of their parent(s).
Nevertheless, one fifth of them had two or more sexual partners during the two-week period, as well as in the two months preceding the study. These are likely to be underestimates of the actual rates of multiple sexual partners since under-reporting in sexual surveys is quite common and generally more common than over-reporting -- particularly among women.
Women did link some of their beliefs of being safe from sexually transmitted conditions to the use of a condom, but they also reported this feeling of safety when there were no condoms used and bodily fluids were exchanged. It seems they based this feeling on a hunch, trust, or wishful thinking.
People may plan to refrain from intercourse, engage in foreplay with the expectation of using a condom at the next stage, or initiate sex believing that they will interrupt the process to do so. Yet they may underestimate: the power of the situation, their desires, or possibly the concerns in the moment about their partner's reactions to their plan for safer sex. Resolutions do break down in the "heat of the moment." It's my strong suspicion that this scenario is not limited to inner-city young adults.
Lessons from sex education and sexually transmitted disease efforts nationwide have not been sufficiently integrated into the private lives of young people in ways that motivate or enable them to choose and follow through on safer sexual practices. It means that we still have a long way to go in reaching and influencing the decision-making processes related to the risks of sexual behaviors. We need to develop more public health and educational interventions to promote healthy sexual behaviors.
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